At the AAO annual meeting in New Orleans, on Nov. 12-15, attendees had the opportunity to peruse the exhibition hall to see the latest technologies and innovations available to the ophthalmic industry. If you missed it, OM contributors offered their top highlights from the 2021 show floor.

DIAGNOSTIC TECHNOLOGY

I-MED Pharma’s Tearcheck dry eye diagnostic and analyzing tool uses white, blue and infrared light to performs nine exams in less than 10 minutes. This includes: an eye fitness test, non-invasive tear breakup time/dynamic tear breakup time, a tear film stability evaluation, an ocular surface inflammatory evaluation, tear meniscus, blink rate, eye redness, infrared meibography, Demodex, an OSDI questionnaire and an abortive blinking exam. “What’s even better is that the Tearcheck results are presented in a final report directly shown on the screen for patients and physicians to see and save,” says Cynthia Matossian, MD, FACS.

MEDICATION

Allergan’s VUITY (pilocarpine HCl ophthalmic solution) 1.25% is a daily, prescription eyedrop for presbyopia that works in as early as 15 minutes and lasts up to 6 hours, as measured on day 30, to improve near and intermediate vision without impacting distance vision. In October 2021, it became the first FDA-approved pharmacologic drug to address presbyopia — patients do not have to rely on a prosthetic device like contact lenses and reading glasses. “Anytime you have a drug that reduces the need for having to wear contacts and reading glasses, that is something that interests me,” says Blake K. Williamson MD, MPH, MS.

For Laura M. Periman, MD, VUITY has the potential “hero factor” for doctors. “It is a lifestyle enhancing medication that helps to soften the sharp angles of the aging changes (such as presbyopia).”

SURGICAL DEVICES AND TECHNOLOGY

Alcon’s SMART Solutions digital health platform is designed to improve clinic-to-OR integration via image-guided technologies and cloud-based planning. The application connects data systems and diagnostic devices, as well as many third-party microscopes. SMART Solutions leverages the open, cloud-based infrastructure and services of Philips HealthSuite, built on Amazon Web Services, to enable surgeons to aggregate, organize and analyze relevant data within one integrated application.

Beyeonics Vision’s Beyeonics One surgical microscope is an open and upgradable digital visualization platform. It is equipped with an ultra-high-resolution camera that processes and transfers digitally enhanced images to a high-resolution, head-wearable display for an immersive and natural stereoscopic 3D-viewing experience. Dr. Williamson says this technology offers a new way to visualize the eye during cataract surgery or refractive surgery. “Just by simply moving the head in one direction or the other, the user can zoom in and out.” Dr. Williamson also adds that he looks forward to the other capabilities that will be later integrated into the system, like intraoperative OCT imaging and the ability to pull up preoperative diagnostics.

Christina Y. Weng, MD, MBA says it was “an immersive experience. Integrated features such as being able to overlay a patient image or health record data are very progressive.”

Steven M. Silverstein, MD, FACS, adds that the “heads-up display surgical technology is remarkably beneficial and growing, especially as pricing comes down to be more competitive with standard operating microscopes.”

Iridex exhibited its products for non-incisional glaucoma procedures, including their Cyclo G6 laser and revised MicroPulse P3 Probe required to perform MicroPulse Transscleral Laser Therapy (TLT). MicroPulse TLT is a versatile treatment option that can be performed before, in combination with and after other glaucoma treatments. In a recent webinar on findings from the International Consensus Group for MicroPulse TLT, Robert Noecker, MD, MBA, said “Patients who are uncontrolled with medical therapy (eg IOP >21 mm Hg) can expect a significant reduction in IOP (25%-45% IOP reduction 1 year after treatment) and a meaningful reduction in medication.”

Johnson & Johnson Vision’s Veritas Vision System is the company’s latest phacoemulsification device. Features include its Hybrid Fluidics Technology, which is designed to minimize post-occlusion surge to protect intraocular structures and provide chamber stability. The system also features an ergonomically designed foot pedal.

LENSAR’s Ally combines femtosecond laser and phacoemulsification in one device. This allows the complete femto laser-assisted cataract procedure to be performed in one session and one location by a single surgeon. “The combination of a femtosecond laser with a phaco system could reignite the use of lasers in cataract surgery by creating a more efficient mode of delivery,” says Mark Kontos, MD.

Separate prepping and repositioning of patients is not necessary, which the company says creates greater OR workflow efficiency. “Ally includes LENSAR’s proprietary automatic iris registration, which eliminates manual transposition of measurements and marking of the eye, further guiding surgeons to achieve better astigmatic outcomes,” says Mitchell A. Jackson, MD. LENSAR plans to submit a 510(k) for regulatory clearance in first quarter 2022 and make Ally commercially available to the US market later this year.

Norlase’s LION laser indirect ophthalmoscope (LIO) combines a green laser photocoagulator with a Keeler indirect ophthalmoscope. The battery-powered LION requires no fiber tether and utilizes an advanced wireless interface with voice control of parameters.

For Dr. Weng, the system was surprisingly lightweight and functions like a regular 532-nm wavelength laser system minus the bulky console and constricting fiber-optic cable. “The portability of this system, with only one cord that connects the headgear to a compact foot pedal, is quite appealing for those of us who work out of multiple settings (eg, satellite clinics, operating rooms, hospital wards, emergency rooms),” she says.

TREATMENT TECHNOLOGY

Lumenis’ OptiLight intense pulsed light (IPL) device is designed to improve signs of dry eye disease due to meibomian gland dysfunction. OptiLight, which was granted De Novo authorization by the FDA in 2021, uses the company’s patented Optimal Pulse Technology. In a multicenter, double-blinded, randomized controlled FDA clinical trial, Lumenis IPL significantly improved tear breakup time, meibum quality and meibomian gland expressibility.

IOLs

AcuFocus Inc.’s IC-8 Small Aperture IOL is an aspheric monofocal lens that uses wavefront-filtering, small aperture optics. The lens is designed to mitigate the harmful visual effects of unfocused peripheral light, allowing only central light rays to focus on the retina and deliver continuous extended depth of focus.

Eric Donnenfeld, MD, says the opportunity to improve quality of vision in some of our most difficult patients makes the IC-8 small aperture a significant advance. He is particularly excited about new technology for two reasons.

“For patients with normal corneas, it will offer over a diopter of near vision without splitting of light and without a significant effect on distance vision,” he says. “The second reason is its ability to improve quality of vision at distance in patients with irregular corneas who have decreased visual acuity and/or dysphotopsias. This includes patients following radial keratotomy, LASIK, PRK, penetrating keratoplasty, keratoconus and corneal scars, to name a few.”

In December, AcuFocus announced receipt of an Approvable Letter from the FDA for the IC-8. The company estimates receipt of an official approval order from the FDA in Q2 2022.

RxSight’s Light Adjustable Lens (LAL) is an adjustable IOL that allows ophthalmologists to fine-tune visual results after cataract surgery. Optimization occurs after the LAL is in its final position and the patient’s eye has healed, overcoming the traditional limitations of preoperative and intraoperative prediction processes. Dr. Kontos is impressed with “the high level of visual acuity the patients are getting along with some extended depth of vision at intermediate.”

LAL is the first FDA-approved IOL that is adjusted postoperatively to improve uncorrected visual acuity.

“The Light Adjustable Lens is my favorite technology over the last year,” adds Dr. Silverstein. “Patients readily understand and embrace the opportunity and benefit of post-implantation adjustment.” OM